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NPI Code Detail

MEDICARE: ELAINE GWOSDZ-GILMAN MD PLLC

MEDICARE: ELAINE GWOSDZ-GILMAN MD PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianK2915TX

General Provider Information

NPI Number : 1720469331
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELAINE GWOSDZ-GILMAN MD PLLC
Provider Business Mailing Address
First Line : 301 MAIN PLZ
Second Line : SUITE 365
City : NEW BRAUNFELS
State : TX
Zip : 78130-5136
Country : US
Telephone Number : 830-237-9386
Fax Number :
Provider Business Practice Location Address
First Line : 2041 SUNDANCE PKWY
Second Line :
City : NEW BRAUNFELS
State : TX
Zip : 78130-2779
Country : US
Telephone Number : 830-625-6700
Fax Number :
Authorized Official
Title or Position : SOLE MEMBER
Name : ELAINE GWOSDZ-GILMAN
Credential : MD
Telephone Number : 830-237-9386
Provider Enumeration Date : 06/09/2015
Last Update Date : 06/09/2015

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